At the heart of Canada’s fentanyl crisis, extreme efforts that US cities may follow

VANCOUVER, B.C. — Beneath a blue tarp that blocks out a gray sky, Jordanna Coleman inhales the smoke from a heated mixture of heroin and methamphetamine, sucking the addictive vapor deep into her lungs.

The drugs and pipe, acquired elsewhere, are hers. But the shelter, the equipment she uses to prepare her fix and the volunteers standing by to respond if she overdoses are provided by a small nonprofit. Funding and supplies come from the city of Vancouver and the province of British Columbia.

“I was outside. It’s warmer in here,” says Coleman, 22, although the tent is open to the damp and chill of a western Canadian winter. “It’s just safer.”

In barely a year, five sites like this one have opened within a few blocks of one another to contend with a surge of fentanyl on Vancouver’s streets. In December, the organization that runs this location, the Overdose Prevention Society, took over a vacant building next door, giving users a clean indoor place to inject drugs. There are 29 similar sites in British Columbia, the epicenter of Canada’s drug crisis, and more across the country.

“To save lives, you need a table, chairs and some volunteers,” said Sarah Blyth, the manager here. “We literally popped it up in one day. And then you have people saving lives. Immediately.”

As fentanyl rampages across North America, several U.S. cities have announced that they will open the first supervised drug-consumption sites like those in Canada. Their plans illustrate the gulf between the two nations: While Justin Trudeau’s government is doubling down on its “harm reduction” approach, any U.S. organization that tries to follow suit would be violating federal law and risking a confrontation with the Justice Department.

U.S. researchers say that at least one underground site is operating on American soil, and they predict that a public operation will open despite the potential consequences.

“That’s the way that drug policy issues have moved forward in this country [over the] last 25 years,” said Alex Kral, an epidemiologist at the think tank RTI International who has studied supervised drug consumption. Cities enduring the deaths, disease, crime and cost of drug epidemics have taken the lead in handing out free needles and distributing the overdose antidote naloxone — sometimes after legal battles.

VANCOUVER, B.C. — Beneath a blue tarp that blocks out a gray sky, Jordanna Coleman inhales the smoke from a heated mixture of heroin and methamphetamine, sucking the addictive vapor deep into her lungs.

The drugs and pipe, acquired elsewhere, are hers. But the shelter, the equipment she uses to prepare her fix and the volunteers standing by to respond if she overdoses are provided by a small nonprofit. Funding and supplies come from the city of Vancouver and the province of British Columbia.

“I was outside. It’s warmer in here,” says Coleman, 22, although the tent is open to the damp and chill of a western Canadian winter. “It’s just safer.”

In barely a year, five sites like this one have opened within a few blocks of one another to contend with a surge of fentanyl on Vancouver’s streets. In December, the organization that runs this location, the Overdose Prevention Society, took over a vacant building next door, giving users a clean indoor place to inject drugs. There are 29 similar sites in British Columbia, the epicenter of Canada’s drug crisis, and more across the country.

“To save lives, you need a table, chairs and some volunteers,” said Sarah Blyth, the manager here. “We literally popped it up in one day. And then you have people saving lives. Immediately.”

As fentanyl rampages across North America, several U.S. cities have announced that they will open the first supervised drug-consumption sites like those in Canada. Their plans illustrate the gulf between the two nations: While Justin Trudeau’s government is doubling down on its “harm reduction” approach, any U.S. organization that tries to follow suit would be violating federal law and risking a confrontation with the Justice Department.

U.S. researchers say that at least one underground site is operating on American soil, and they predict that a public operation will open despite the potential consequences.

“That’s the way that drug policy issues have moved forward in this country [over the] last 25 years,” said Alex Kral, an epidemiologist at the think tank RTI International who has studied supervised drug consumption. Cities enduring the deaths, disease, crime and cost of drug epidemics have taken the lead in handing out free needles and distributing the overdose antidote naloxone — sometimes after legal battles.